Threat to NHS ‘comes from reforms’

The threat to the NHS over the next five years is not privatisation but further “ill-thought through” reforms such as those brought in by the coalition Government, a report has warned.

The Centre for Economic Performance (CEP) said the private sector currently plays a very small role in direct service provision in the NHS and no party is planning to substantially increase this.

But it warned that whoever comes into power in May needs to focus on improving patient care at the same time as balancing the expenditure constraints as a result of the deficit it is currently in.

Referring to pledges from the main political parties concerning the NHS, it said the specifics of the measures outlined by the Conservatives were “scant”, while “little detail has emerged” of Labour’s promises.

The report said the NHS absorbs a fifth of all public spending and constitutes 8% of UK GDP, with this percentage set to fall over the next parliament.

At the same time as this, recent NHS spending has been relatively low, growing only at 0.7% per year in real terms between 2010 and 2015, well below the long-run average growth rate of 4% per annum.

The CEP said that although the coalition Government has been “partly successful” in achieving efficiency savings, growing demands will mean the issue is only set to get worse.

It pointed out that predictions by NHS England show that even with continued efficiency savings, there will be a minimum shortfall of £8 billion in the NHS budget by 2020.

The report also said that the controversial Health and Social Care Act 2012, which brought about huge reform of the NHS, appears to have been “largely ineffective” in improving services.

It also called for the Cancer Drug Fund, which provides additional money for certain drugs, to be scrapped.

“The threat to the NHS is certainly not going to be creeping privatisation, but rather on extending or adding more ill-thought through reforms that target inputs, rather than focusing on improving the value of NHS outcomes,” it concluded.

“The important matter to concentrate on here is what achieves higher quality service provision, given the expenditure constraints.”

The report’s author, Professor Alistair McGuire, said: “The NHS will face more severe financial pressures over the next few years than ever before. Unlike in many other parts of the public sector, the factors of an ageing population and people’s expectations mean that the usual health rise as a fraction of national income is now predicted to fall substantially.

“Since no party is proposing NHS charges nor an increase in the use of the private sector above its current – very low – levels, there is no risk of ‘privatisation’ of the NHS.”